OBJECTIVES: To examine the economic burden and healthcare utilizations of patients diagnosed with chronic kidney disease (CKD) in the U.S. veteran population. METHODS: A retrospective database analysis was performed using the Veterans Health Administration (VHA) Medical SAS datasets (01OCT2008-30SEP2012). Patients diagnosed with CKD were identified using International Classification of Disease 9th Revision Clinical Modification (ICD-9-CM) diagnosis codes 585.xx, 250.4xx, 791.0x, 583.xx, and 403.xx. The first diagnosis date was designated as the index date. A group of non-CKD patients of the same age, region, gender and index year were identified and matched on baseline Charlson Comorbidity Index (CCI) as the comparison group with a randomly chosen index date to minimize selection bias. Patients in both groups were required to be at least 18 years old, and have continuous health plan benefits 1 year before and 1 year after the index date. One-to-one propensity score matching was used to compare the healthcare costs and utilizations during the follow-up period between the CKD and comparison groups, adjusted for baseline demographic and clinical characteristics. RESULTS: A total of 477,078 patients were identified for the CKD cohort and the comparison cohort. After 1:1 matching, 155,324 of patients were matched from each group, and the baseline characteristics were well-balanced. CKD Patients incurred higher healthcare utilizations in inpatient (17.00% vs. 2.84%, p<0.01), emergency room (17.81% vs. 6.64%, p<0.01), physician office (99.28% vs. 67.92%, p<0.01), outpatient (99.36% vs. 68.69%, p<0.01), and pharmacy visits (91.16% vs. 72.61%, p<0.01). The CKD group also had higher patient expenditures in inpatient ($6,228 vs. $802, p<0.01), emergency room ($194 vs. $62, p<0.01), physician office ($3,287 vs. $1,516, p<0.01), outpatient ($3,788 vs. $1,715) and pharmacy ($848 vs. $490, p<0.01) than patients in the comparison group. CONCLUSIONS: CKD patients had a significantly higher burden of illness compared to a similar comparison group of non-CKD patients.